Hospitalized COVID-19 Patients Have More, More Severe Complications vs Patients with Influenza

October 23, 2020

The first study to compare COVID-19 and influenza complications in hospitalized patients found COVID-19 patients more likely to be admitted to ICU and to die.

Patients hospitalized with COVID-19 experienced many more—and more serious—complications than patients admitted with influenza. COVID-19 patients had longer inpatient stays, were more likely to be admitted to intensive care, and more likely to die.

These findings come from a study from the US Veterans Health Administration published in the British Medical Journal on October 22, 2020. It is likely the first study to report comparative data for in-hospital complications between patients infected with the 2 circulating respiratory viruses.

The study compared in-hospital complications experienced by 3948 patients with laboratory- confirmed COVID-19 admitted to a VA hospital between March 1 and May 31, 2020 with those of 5453 patients with confirmed flu admitted between October 1, 2018 and February 1, 2020. COVID-19 patients were slightly older than flu patients (mean 70 vs 69 years).

CLICK THROUGH THE RESULTS.

Almost all patients admitted to the hospital with COVID-19 and influenza had underlying conditions.

Nearly half (48.3%) of COVID-19 patients were black but less than one-quarter (24.7%) of flu patients were black.

Compared with flu patients, COVID-19 patients had…≈19x the risk for acute respiratory distress syndrome (ARDS). More than 2x the risk for myocarditis, deep vein thrombosis, pulmonary embolism, intracranial hemorrhage, acute hepatitis/liver failure, bacteremia, and pressure ulcers.

COVID-19 patients, vs flu patients, also were ... 5x as likely to die (21% vs 3.8%); hospitalized almost 3x as long; twice as likely to be admitted to ICU.

COVID-19 patients had a higher risk of respiratory complications vs flu patients: Pneumonia, 2x. Respiratory failure 1.7x. ARDS 19x. Pneumothorax 3.5x.

9 complications found more commonly among racial/ethnic minority patients vs white patients: Pneumonia, Respiratory failure, ARDS, Hypertensive crisis, Cerebral ischemia/infarction, Intracranial hemorrhage, Acute kidney failure, Initiation of dialysis, Sepsis.

Even after adjustment for age and underlying conditions, a higher risk of respiratory, neurologic, and renal complications and of sepsis was seen in non-Hispanic black patients with COVID-19 vs white patients with COVID-19.

Hospitalized COVID-19 Patients Have More, More Severe Complications vs Patients with Influenza

Grace Halsey